Markers of bone turnover after 12 months of exercise in patients with chronic kidney disease 3-5: a post-hoc analysis of RENEXC - a randomized controlled trial
Abstract
Background: Bone and mineral disorders are common in patients with chronic kidney disease (CKD), leading to poor quality of life, high fracture risk, and increased morbidity and cardiovascular mortality. Parathyroid hormone (PTH) and bone-specific alkaline phosphatase (bALP) are frequently used to assess bone turnover, but markers such as procollagen type I N-terminal propeptide (intact PINP) and tartrate-resistant acid phosphatase isoform 5b (TRAP5b), which reflect bone formation and resorption, may provide more specific insights into bone remodeling. This study aims to investigate the effects of balance and strength exercises on bone turnover markers in patients with CKD not undergoing kidney replacement therapy.
Methods: This study is a post-hoc sub-analysis of the RENEXC trial, a randomized controlled exercise intervention lasting 12 months. A total of 151 CKD stage 3-5 patients were randomly assigned to either strength or balance exercise, both combined with endurance exercise. Exercise intensity was monitored using the Borg Rating of Perceived Exertion scale. Bone turnover markers, including intact PINP and TRAP5b, were measured at baseline and after 12 months.
Results: Over 12 months, within-group changes in bone turnover markers were not statistically significant. In the strength group, intact PINP showed a non-significant increase and TRAP5b a slight decrease, while in the balance group intact PINP tended to decrease and TRAP5b remained stable. After adjustment for…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 12 participants or records.
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